Ethnic group inequalities in coverage with reproductive, maternal and child health interventions: cross-sectional analyses of national surveys in 16 Latin American and Caribbean countries.

BACKGROUND: Latin American and Caribbean populations include three main ethnic groups: indigenous people, people of African descent, and people of European descent. We investigated ethnic inequalities among these groups in population coverage with reproductive, maternal, newborn, and child health interventions. METHODS: We analysed 16 standardised, nationally representative surveys carried out from 2004 to 2015 in Latin America and the Caribbean that provided information on ethnicity or a proxy indicator (household language or skin colour) and on coverage of reproductive, maternal, newborn, and child health interventions. We selected four outcomes: coverage with modern contraception, antenatal care coverage (defined as four or more antenatal visits), and skilled attendants at birth for women aged 15-49 years; and coverage with three doses of diphtheria-pertussis-tetanus (DPT3) vaccine among children aged 12-23 months. We classified women and children as indigenous, of African descent, or other ancestry (reference group) on the basis of their self-reported ethnicity or language. Mediating variables included wealth quintiles (based on household asset indices), woman's education, and urban-rural residence. We calculated crude and adjusted coverage ratios using Poisson regression. FINDINGS: Ethnic gaps in coverage varied substantially from country to country. In most countries, coverage with modern contraception (median coverage ratio 0·82, IQR 0·66-0·92), antenatal care (0·86, 0·75-0·94), and skilled birth attendants (0·75, 0·68-0·92) was lower among indigenous women than in the reference group. Only three countries (Nicaragua, Panama, and Paraguay) showed significant gaps in DPT3 coverage between the indigenous and the reference groups. The differences were attenuated but persisted after adjustment for wealth, education, and residence. Women and children of African descent showed similar coverage to the reference group in most countries. INTERPRETATION: The lower coverage levels for indigenous women are pervasive, and cannot be explained solely by differences in wealth, education, or residence. Interventions delivered at community level-such as vaccines-show less inequality than those requiring access to services, such as birth attendance. Regular monitoring of ethnic inequalities is essential to evaluate existing initiatives aimed at the inclusion of minorities and to plan effective multisectoral policies and programmes. FUNDING: The Bill & Melinda Gates Foundation (through the Countdown to 2030 initiative) and the Wellcome Trust.

Mortalidad por VIH/Sida en Guatemala: Evolución 2005-2013 / Mortality due to HIV / AIDS in Guatemala: Evolution 2005-2013

Introducción: En Guatemala el primer caso de VIH fue notificado en el año de 1984, desde entonces la curva de casos ha presentado tendencia ascendente, con estabilización incipiente en los últimos años, el país con una epidemia de tipo concentrada. Objetivos: Caracterizar la mortalidad por VIH en Guatemala durante el período 2005-2013. Método: Estudio descriptivo, de corte transversal. Para el análisis de mortalidad, los indicadores y el cálculo de AVPP por VIH/sida se utilizaron las bases de datos de mortalidad y proyecciones de población del Instituto Nacional de Estadística (INE). Se consideraron para el procesamiento los códigos de los Grupos de B-20 a B-24 de la CIE -10...(AU)

Comparative study using different infrared zones of the solventless activation of organic reactions.

In this work, the results of a study comparing the use of irradiation from different regions of the infrared spectrum for the promotion of several organic reactions, are presented and discussed. This use of eco-conditions provides a green approach to chemical synthesis. A set of ten different organic reactions were evaluated, including the Knoevenagel, Hantzsch, Biginelli and Meldrum reactions. It is important to highlight the use of a commercial device that produces infrared irradiation in the near infrared region and its distribution by convection providing heating uniformity, significantly reducing reaction times, achieving good yields and proceeding in the absence of solvent. It is also worth noting that a variety of different reactions may be performed at the same time. Finally, the products obtained were identified using TLC, together with corresponding MS-data, complementarily in comparison of NMR (1)H and (13)C data with literature information.

Programa de Entrenamiento en Epidemiología de Campo para Centroamérica y El Caribe: FETP Guatemala

Volumen de trabajo del Entrenado FETP Guatemala. Contiene Investigaciones de campo (brotes rubéola, enfermedad diarreica, gastroenteroclitis, meningitis), Análisis de Vigilancia (indicadores de mortalidad infantil y materna, prevención y control de enfermedades, desnutrición), estudios epidemiológicos, publicaciones.